Target Market Determination | MIPS Indemnity Insurance

Target Market Determination

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See our Member Handbook Combined PDS and FSG which includes the indemnity insurance policy that is a benefit of MIPS membership.

Date of preparation 1 October 2021 

Product: MIPS Assist

This Target Market Determination (TMD) applies to the MIPS Assist product referred to in the Member Handbook Combined PDS and FSG. It does not apply to the Indemnity Insurance Policy that is a benefit of Membership

This TMD is prepared under section 994B of the Corporations Act 2001 (Cth). It sets out the target market for the product, triggers to review the target market, and certain other information.

This document is not a product disclosure statement and is not a summary of the product features or terms of the product. It does not take into account your objectives, financial situation or needs. If you are interested in joining MIPS, you should carefully read the Member Handbook which contains the Combined Product Disclosure Statement and Financial Services Guide before making a decision whether to proceed.

Description

MIPS Assist is a discretionary benefit. MIPS Assist can provide assistance with non healthcare risks from your clinical activities not covered by insurance arrangements such as disputes arising in connection with members’ employer, professional college or association, or regulator.

MIPS Assist is available as part of MIPS membership as:

  • a bundled product with medical indemnity insurance cover under MIPS’ master policy, which meets the requirements of the Australian Healthcare Practitioner Regulation Agency (AHPRA); or
  • a standalone product without access to medical indemnity insurance cover.

Key attributes

MIPS Assist (standalone)

The key attributes of the MIPS Assist product are:

  • assistance, including payment of defence costs, may be provided for disputes that arise in connection with your employment, university, professional college or association and regulator issues.
  • assistance is discretionary and considered on a case by case basis.

MIPS Assist (bundled with medical indemnity insurance cover)

MIPS Assist is also available as part of a bundled product which includes medical indemnity insurance cover. Accordingly, you should also be aware of the key attributes of the medical indemnity insurance cover component, which is under a master policy held by MIPS. The key attributes are:

  • designed for healthcare practitioners and healthcare students to meet AHPRA registration requirements;
  • insurance cover for civil liability arising from healthcare provided by the member to a maximum of $20 million in the aggregate and in excess of the $10 million required by AHPRA healthcare boards for medical, dental and nuclear medicine practitioners;
  • insurance cover to the value of $10 million and one automatic reinstatement of the same value for dental and nuclear medicine practitioners;
  • run-off cover for practitioners;
  • fixed sum payout where the member is diagnosed with HIV, Hepatitis B or Hepatitis C; and
  • insurance cover for civil liability of administrative staff and assistants employed by the member or their company or business where the member is the sole practitioner and owner.

The insurance product and its key attributes are likely to meet the needs of consumers in the target market because appropriate professional indemnity insurance arrangement is a mandatory requirement of AHPRA registration. As part of the bundled product, MIPS Assist also provides the potential for assistance, including payment of defence costs, which may be provided for non healthcare risks from your clinical activities not covere by insurance arranegments such as disputes that arise in connection with your employment, university, professional college or association and regulator issues. Assistance is discretionary and considered on a case by case basis

Consumer objectives, financial situation and needs

The likely objectives, financial situation and needs of customers within the target market for the product are:

Client objectives and needs

  • For MIPS Assist as a standalone product: a person who undertakes healthcare practice or is studying in a discipline that leads to registration as an AHPRA registered healthcare practitioner and is employed, a member of a professional college or association, or subject to oversight by a regulator in respect of their healthcare practice or studies.
  • For MIPS Assist as a bundled product which includes medical indemnity insurance cover: A person:
    • who undertakes healthcare practice or is studying in a discipline that leads to registration as an AHPRA registered healthcare practitioner and may be liable for civil liability to third parties when undertaking healthcare practice; or
    • is seeking or has registration from AHPRA and has a mandatory registration standard to hold a professional indemnity insurance policy .

Financial situation

  • For members other than students: A person who is engaged in the practice of healthcare and has the financial capacity to pay the MIPS membership Fee, noting that the fee may vary depending on the person’s indemnity arrangement, craft group, private practice hours, billings or salary and whether MIPS Assist is purchased as a standalone product or bundled product with medical indemnity insurance cover.
  • For students: No fee applies.

Negative target market

  • MIPS Assist (bundled or standalone) is not suitable for people who are not healthcare practitioners or people who are not studying a discipline that does not lead to registration as an AHPRA registered healthcare practitioner.
  • MIPS Assist as a bundled product may not be suitable for people who will be subject to restricted cover or conditions under the medical indemnity insurance component of the bundled product. MIPS will inform the person if a determination has been made to restrict the cover or impose conditions on the insurance component of the bundled product.

Distribution Conditions

The following distribution conditions apply to MIPS Assist:

  • Before arranging the sale of the product, MIPS  must make available to the prospective (or renewal) member a list of Membership Categories, within the Member Handbook, and the prospective (or renewal) member is required to confirm that they fall within a specific Membership Category.
  • MIPS must comply with disclosure obligations including providing the prospective (or renewal) member with a copy of the Member Handbook Combined Product Disclosure Statement and Financial Services Guide.
  • If the prospective (or renewal) member will not be permitted to access MIPS Assist due to a determination made by MIPS, MIPS must inform the prospective (or renewal) member as soon as possible and advise them that the product may not be suitable for them.
  • If the prospective (or renewal) member will be subject to restricted cover or conditions under the medical indemnity insurance component of MIPS Assist as a bundled product, MIPS must inform the prospective (or renewal) member as soon as possible and advise them that the product may not be suitable for them.

These distribution conditions make it likely that the people who acquire the product are in the target market because they are required to review and select a Membership Category. MIPS will advise the person, before the product is issued or renewed, if they will be unable to access MIPS Assist or where cover may be restricted or subject to conditions under the insurance component of MIPS Assist as a bundled product.

Review Triggers

The review triggers for the product are:

  • Any changes to product eligibility for MIPS membership or changes to the MIPS Constitution
  • A significant:
    • change in law, regulation or policy that affects MIPS Assist or medical indemnity insurance arrangements or requirements
    • sustained increase in the requests received and approved/denied for MIPS Assist and claims ratios for the medical indemnity insurance policy
    • sustained fluctuation on the number of paid, denied and withdrawn requests for the product
    • sustained decrease on the number of MIPS memberships that can be reasonably attributed to product deficiencies  
    • sustained increase in membership retention or cancellation rates
    • sustained increase in complaints regarding product design, product availability, claims experience or distribution conditions. amount of feedback from members that product is not suitable including feedback in relation to the medical indemnity insurance policy
  • Industry or media reports of healthcare practitioners or students left un-defended or with civil liabilities due to healthcare they provided.
  • Any indication that MIPS could not reasonably continue to meet its claims liabilities

Target Market Determination review

This TMD will be reviewed no later than the following periods:

  • The first review period: 2 years and 3 months after the original date of this TMD
  • Ongoing review period: At least every 2 years and 3 months following the first review

Reporting Complaints

Nature of complaint

Timeframe for reporting to MIPS (the issuer)

Sales outside of target market

At the time of sale

Complaints

Monthly

Significant dealing outside of target market

As soon as practicable and within 10 business days after becoming aware

Reporting Information to assess the TMD

Kinds of information:

Type of information

Reporting period for when information should be provided to the issuer

Change in regulation, legislation, AHPRA policy or ASIC policy

As soon as details of the change are made available

Expected and actual (for both MIPS Assist and MIPS Assist as a bundled product):

  • ratios of requests received and approved/denied for MIPS Assist and claims ratios for the medical indemnity insurance policy;
  • number of paid, denied and withdrawn requests for MIPS Assist and claims for the medical indemnity insurance policy;
  • number of MIPS Assist products issued;
  • number of MIPS Memberships issued; and
  • membership lapse or cancellation rates.

On an annual basis

Complaints

Monthly

Feedback received from members

Within 10 business days